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Larger and deeper ventricular lesions using a novel expandable spherical monopolar irrigated radiofrequency ablation catheter.
J Cardiovasc Electrophysiol. 2019 09; 30(9):1644-1651.JC

Abstract

BACKGROUND

Radiofrequency (RF) ablation is an established treatment for ventricular tachycardia (VT). However, the inability of current RF catheters to address deep or large substrate may explain most of the clinical failures.

OBJECTIVES

The aim of this study is to assess the efficacy and safety of ablation in the left ventricle (LV) in sheep using a novel 8-Fr deflectable ablation catheter (Sphere-9; Affera, Inc) with a 9-mm expandable spherical monopolar irrigated RF tip vs a standard RF irrigated catheter (Biosense Webster, Diamond Bar, CA). The impact on tissue was assessed on local bipolar electrograms (from nine uniformly distributed mini surface electrodes and an internal central reference electrode), as well as on direct lesion measurement post mortem.

METHODS AND RESULTS

Eleven sheep underwent LV endocardial ablation in healthy tissue using the Sphere-9 catheter (n = 6), or a conventional irrigated RF catheter (n = 5). Twenty lesions were created with the Sphere-9 (current limit: 2.7 A; temp. limit: 60°C; irrigation: 30 mL/min; and duration: 60-120 seconds). Local bipolar electrograms at the surface of the catheter disappeared during RF delivery in 17 of 20 (85%) lesions. The mean lesion volume was 1707 ± 771 mm 3 (length: 15.8 ± 3.3 mm; width: 11.6 ± 4.2 mm; and depth: 10.3 ± 2.9 mm). Twenty-five lesions were created with a standard RF irrigated catheter (power control 35 W; irrigation: 30 mL/min; duration: 60 seconds; volume 537 ± 398 mm 3 ; length: 8.2 ± 2.3 mm; width: 5.2 ± 1.8 mm; and depth: 5.5 ± 2.4 mm). The novel spherical RF catheter created significantly larger lesions (P < .001 for measurements in all dimensions). There were no steam pops with the novel ablation catheter vs one with the conventional catheter.

CONCLUSIONS

This novel spherical monopolar irrigated RF catheter creates lesions that are twice as large and deep as a standard irrigated RF catheter.

Authors+Show Affiliations

IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.IHU LIRYC, CHU de Bordeaux, University of Bordeaux, Bordeaux-Pessac, France.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31347223

Citation

Kitamura, Takeshi, et al. "Larger and Deeper Ventricular Lesions Using a Novel Expandable Spherical Monopolar Irrigated Radiofrequency Ablation Catheter." Journal of Cardiovascular Electrophysiology, vol. 30, no. 9, 2019, pp. 1644-1651.
Kitamura T, Hocini M, Bourier F, et al. Larger and deeper ventricular lesions using a novel expandable spherical monopolar irrigated radiofrequency ablation catheter. J Cardiovasc Electrophysiol. 2019;30(9):1644-1651.
Kitamura, T., Hocini, M., Bourier, F., Martin, R., Takigawa, M., Frontera, A., Thompson, N., Cheniti, G., Vlachos, K., Martin, C. A., Lam, A., Duchateau, J., Pambrun, T., Denis, A., Sacher, F., Derval, N., Cochet, H., Haïssaguerre, M., & Jaïs, P. (2019). Larger and deeper ventricular lesions using a novel expandable spherical monopolar irrigated radiofrequency ablation catheter. Journal of Cardiovascular Electrophysiology, 30(9), 1644-1651. https://doi.org/10.1111/jce.14089
Kitamura T, et al. Larger and Deeper Ventricular Lesions Using a Novel Expandable Spherical Monopolar Irrigated Radiofrequency Ablation Catheter. J Cardiovasc Electrophysiol. 2019;30(9):1644-1651. PubMed PMID: 31347223.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Larger and deeper ventricular lesions using a novel expandable spherical monopolar irrigated radiofrequency ablation catheter. AU - Kitamura,Takeshi, AU - Hocini,Mélèze, AU - Bourier,Felix, AU - Martin,Ruairidh, AU - Takigawa,Masateru, AU - Frontera,Antonio, AU - Thompson,Nathaniel, AU - Cheniti,Ghassen, AU - Vlachos,Konstantinos, AU - Martin,Claire A, AU - Lam,Anna, AU - Duchateau,Josselin, AU - Pambrun,Thomas, AU - Denis,Arnaud, AU - Sacher,Frédéric, AU - Derval,Nicolas, AU - Cochet,Hubert, AU - Haïssaguerre,Michel, AU - Jaïs,Pierre, Y1 - 2019/08/01/ PY - 2019/05/13/received PY - 2019/07/06/revised PY - 2019/07/17/accepted PY - 2019/7/28/pubmed PY - 2020/10/6/medline PY - 2019/7/27/entrez KW - ablation KW - novel ablation catheter KW - spherical monopolar irrigated ablation catheter KW - ventricular tachycardia SP - 1644 EP - 1651 JF - Journal of cardiovascular electrophysiology JO - J Cardiovasc Electrophysiol VL - 30 IS - 9 N2 - BACKGROUND: Radiofrequency (RF) ablation is an established treatment for ventricular tachycardia (VT). However, the inability of current RF catheters to address deep or large substrate may explain most of the clinical failures. OBJECTIVES: The aim of this study is to assess the efficacy and safety of ablation in the left ventricle (LV) in sheep using a novel 8-Fr deflectable ablation catheter (Sphere-9; Affera, Inc) with a 9-mm expandable spherical monopolar irrigated RF tip vs a standard RF irrigated catheter (Biosense Webster, Diamond Bar, CA). The impact on tissue was assessed on local bipolar electrograms (from nine uniformly distributed mini surface electrodes and an internal central reference electrode), as well as on direct lesion measurement post mortem. METHODS AND RESULTS: Eleven sheep underwent LV endocardial ablation in healthy tissue using the Sphere-9 catheter (n = 6), or a conventional irrigated RF catheter (n = 5). Twenty lesions were created with the Sphere-9 (current limit: 2.7 A; temp. limit: 60°C; irrigation: 30 mL/min; and duration: 60-120 seconds). Local bipolar electrograms at the surface of the catheter disappeared during RF delivery in 17 of 20 (85%) lesions. The mean lesion volume was 1707 ± 771 mm 3 (length: 15.8 ± 3.3 mm; width: 11.6 ± 4.2 mm; and depth: 10.3 ± 2.9 mm). Twenty-five lesions were created with a standard RF irrigated catheter (power control 35 W; irrigation: 30 mL/min; duration: 60 seconds; volume 537 ± 398 mm 3 ; length: 8.2 ± 2.3 mm; width: 5.2 ± 1.8 mm; and depth: 5.5 ± 2.4 mm). The novel spherical RF catheter created significantly larger lesions (P < .001 for measurements in all dimensions). There were no steam pops with the novel ablation catheter vs one with the conventional catheter. CONCLUSIONS: This novel spherical monopolar irrigated RF catheter creates lesions that are twice as large and deep as a standard irrigated RF catheter. SN - 1540-8167 UR - https://www.unboundmedicine.com/medline/citation/31347223/Larger_and_deeper_ventricular_lesions_using_a_novel_expandable_spherical_monopolar_irrigated_radiofrequency_ablation_catheter_ DB - PRIME DP - Unbound Medicine ER -